SERVICE CPT SERVICE CPT SERVICE CPT OFFICE - Olios Health

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SERVICE

CPT OFFICE CONSULT

SERVICE

CPT

SERVICE

DESTRUCTION (MAL)

CPT

SURGICAL PROCEDURES

Consult - Hospital

$437.50

99251

Trunk/Arm/Leg – Shave 15

$ 175.00

17111

Cryotherapy

$ 60.00

17340

Skin Peel

$ 150.00

17360

MOHS

DISCHARGE INSTRUCTIONS

1st Face, Head, Neck

17311

Each additional

17312

1st Trunk, Arm

17313

Each additional

17314

RETURN TO OFFICE:

FOR:

Notes and Comments: ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ _____________________________________________________________________________________________

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SERVICE CPT SERVICE CPT SERVICE CPT OFFICE - Olios Health

SERVICE CPT OFFICE CONSULT SERVICE CPT SERVICE DESTRUCTION (MAL) CPT SURGICAL PROCEDURES Consult - Hospital $437.50 99251 Trunk/Arm/Leg – S...

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